For many of the large population of people with paraplegia the preferred method of mobility is a manual wheelchair. Manual Wheelchair Users (MWUs) prefer self-propulsion because of its exercise benefits, independence and flexibility when compared to the alternative of an electric powered wheelchair. Among the MWU population, arm and shoulder injuries leading to an inability to propel a manual wheelchair are common. This secondary disability condition leads to a reduction in quality of life and increased societal costs because independence and flexibility is diminished and lack of exercise and associated movement can lead to other heath problems such as obesity and pressure ulcers. The only solution currently available to a MWU who has an injury that prevents self-propulsion is the use of an electric powered chair, or power add-on unit. Studies have shown that over 50% of manual wheelchair users eventually experience an injury that limits one or more of their activities of daily living. Research has linked the cause of these debilitating injuries to the biomechanics of wheelchair design. On a positive basis, preliminary research suggests wheelchair injuries can be reduced by modifying the biomechanics of key wheelchair design variables such as pushrim moments and rear axle placement. The subject of this grant proposal, the SMARTWheel, is being developed to achieve the goal of reducing injury and concomitant secondary disability of MWUs. The SMART will make possible injury reduction because it will be able to simply, accurately and cost effectively measure the key biomechanic variables associated with wheelchair design. By using the SMARTWheel to understanding the mechanisms that contribute toward the development of arm and shoulder pain among MWUs with paraplegia, we can begin the task of injury prevention. Furthermore, we may be able to develop other means of treating arm pain among manual wheelchair users besides the prescription of an electric powered wheelchair. PROPOSED COMMERCIAL APPLICATIONS: As proof of the SMARTWheeI commercial viability several leading research institutions such as Hong Kong Polytechnic and Children's Hospital of Toronto have already purchased the SMARTWheel to better understand the biomechanics of wheelchair design. They have made the commitment to the SMARTWheel concept despite the fact that the device in its current form is difficult to use because it is a prototype without the standard hardware, software and mechanical design features it needs to be a commercially viable product.